Editing Opium (section)

=== Consumption ===
[[File:Akha man with opium pipe.jpg|thumb|right|An [[Akha people|Akha]] man smokes a pipe containing opium mixed with tobacco.]]
In the industrialized world, the United States is the world's biggest consumer of prescription opioids, with Italy being one of the lowest, because of tighter regulations on prescribing narcotics for pain relief.<ref>{{cite journal|title=Oral morphine consumption in Italy and Sicily|author=S. Mercadante|journal=Journal of Pain and Symptom Management|year=1998|volume=15|issue=4|pages=227–30|doi=10.1016/S0885-3924(98)00368-6|pmid=9601157|df=mdy-all|doi-access=free}}</ref> Most opium imported into the United States is broken down into its [[alkaloid]] constituents, and whether legal or illegal, most current drug use occurs with processed derivatives such as heroin rather than with unrefined opium.

[[Intravenous injection]] of opiates is most used: by comparison with injection, "dragon chasing" (heating of heroin on a piece of foil), and [[madak]] and "ack ack" (smoking of cigarettes containing tobacco mixed with heroin powder) are only 40 percent and 20 percent efficient, respectively.<ref>{{cite journal|title=An Assessment Of Inhalation As A Mode Of Administration Of Heroin By Addicts|url=http://jpet.aspetjournals.org/cgi/content/abstract/154/1/142|author1=Benjamin Pui-Nin Mo |author2=E. Leong Way |journal=Journal of Pharmacology and Experimental Therapeutics|volume=154|issue=1|date=October 1, 1966|pages=142–151|access-date=June 6, 2007|pmid=5924312}}</ref> One study of British heroin addicts found a 12-fold excess mortality ratio (1.8 percent of the group dying per year).<ref>{{cite journal|title=Acute Heroin Overdose|author=Karl A. Sporer, M.D.|date=April 6, 1999|volume=130|issue=7|pages=584–590|doi=10.7326/0003-4819-130-7-199904060-00019|pmid=10189329|journal=Annals of Internal Medicine|s2cid=22949289}}</ref> Most heroin deaths result not from overdose ''per se'', but combination with other depressant drugs such as [[alcohol (drug)|alcohol]] or [[benzodiazepine]]s.<ref>{{cite journal |vauthors=Darke S, Zador D |title=Fatal heroin 'overdose': a review |journal=[[Addiction (journal)|Addiction]] |volume=91 |issue=12 |pages=1765–72 |date=December 1996 |pmid=8997759 |doi=10.1046/j.1360-0443.1996.911217652.x }}</ref>

The smoking of opium does not involve the [[pyrolysis|burning]] of the material as might be imagined. Rather, the prepared opium is indirectly heated to temperatures at which the active alkaloids, chiefly morphine, are vaporized. In the past, smokers would use a specially designed [[opium pipe]] which had a removable knob-like pipe-bowl of fired earthenware attached by a metal fitting to a long, cylindrical stem.<ref>{{cite web|url=https://softfamous.com/category/windows/network/vpn/|title=Anonymous Proxy|website=Softfamous.com|access-date=June 11, 2022}}</ref> A small "pill" of opium about the size of a pea would be placed on the pipe-bowl, which was then heated by holding it over an [[opium lamp]], a special oil lamp with a distinct funnel-like chimney to channel heat into a small area. The smoker would lie on his or her side in order to guide the pipe-bowl and the tiny pill of opium over the stream of heat rising from the chimney of the oil lamp and inhale the vaporized opium fumes as needed. Several pills of opium were smoked at a single session depending on the smoker's tolerance to the drug. The effects could last up to twelve hours.

In [[Eastern world|Eastern culture]], opium is more commonly used in the form of [[paregoric]] to treat [[diarrhea]]. This is a weaker solution than [[laudanum]], an alcoholic tincture which was prevalently used as a pain medication and sleeping aid. Tincture of opium has been prescribed for, among other things, severe diarrhea.<ref>{{cite web|url=http://drugs.uta.edu/laudanum.html|title=Laudanum|access-date=May 4, 2007|url-status=dead|archive-url=https://web.archive.org/web/20070531225628/http://drugs.uta.edu/laudanum.html|archive-date=May 31, 2007|df=mdy-all}}</ref> Taken thirty minutes prior to meals, it significantly slows intestinal motility, giving the intestines greater time to absorb fluid in the stool.

Despite the historically negative view of opium as a cause of addiction, the use of morphine and other derivatives isolated from opium in the treatment of chronic pain has been reestablished. If given in controlled doses, modern opiates can be an effective treatment for [[neuropathic pain]] and other forms of chronic pain.<ref name="BallantyneJane">{{cite journal |last1=Ballantyne |first1=JC |last2=Mao |first2=J |title=Opioid therapy for chronic pain. |journal=The New England journal of medicine |date=13 November 2003 |volume=349 |issue=20 |pages=1943-53 |doi=10.1056/NEJMra025411 |pmid=14614170}}</ref>